Regulations Would Dramatically Affect Radiation
Oncology
ACRO has gained the support of several Members of Congress in its fight to curtail proposed Medicare reimbursements that would have a negative
impact on your profession! A detailed update follows, but it's important to follow up and keep the pressure on the CMS with letters from patients and other like minded doctors! Included in this alert are links to pre-written letters and copies of documents circulating the Halls of Congress. Take a look!
Congressional Support:
ACRO appreciates the support of Reps. Lois Capps (D-Calif.),
Sue Myrick (R-N.C.), Mike Rogers (R-Mich.) and Parker Griffith, M.D. (D-Ala.)
and over 60 other Members of Congress for their leadership by sponsoring a
letter to CMS on this issue. The letter is available by clicking here.
In the Senate, Sens. Lincoln and Burr also have organized a sign-on letter to
CMS on the issue, please click here to see the letter from the senators.
ACRO encourages its membership to contact their Senators and
ask them to sign the Lincoln/Burr letter before the new September 15
deadline.
Proposed Cuts:
Recently, CMS
released its proposed physician reimbursement rule for 2010. Several
components of the CMS proposal would dramatically reduce reimbursement for
radiation oncologists. ACRO believes that such drastic changes would seriously destabilize the foundation of radiation cancer care.
The substantial
reductions in revenue would likely mean that many individuals and facilities could not continue to provide
services. ACRO is deeply concerned
that patients would experience delays in care and radiation oncologists would
be challenged to provide the personalized medical care that each patient expects. To understand the potential reductions here are the reimbursement
changes for just a few key radiation oncology codes:
CPT®
77014 CT guidance, decreases 32%
CPT®
77336 physics consult decreases 43%
CPT®
77413 treatment delivery decreases 14%
CPT®
77414 treatment delivery decreases 16%
CPT®
77418 IMRT decreases 44%
CPT®
77421 stereoscopic guidance decreases 19%
These
devastating effects are a result of the following changes proposed by CMS:
Increasing the
equipment utilization rate from 50% to 90%. CMS estimates that this results in an overall reduction of 5% for
radiation oncology; however, the impact on specific codes is far greater. CMS has proposed to treat therapeutic
equipment costing over $1million in the same way as diagnostic radiology equipment.
Updating
practice expense data from recent surveys without sharing the data,
allowing adequate time to review the full impact of the change and
substantially destabilizing radiation oncology revenue as a result. CMS has not used a transparent process
that allows specialties to review the information and determine whether
standard data precision requirements are in place. The data changes do not adequately capture the resources needed
to provide patient care and is contrary to CMS's own policy of using a
methodology that appropriate reflects practice expenses. CMS estimates that using the new data reduces
overall payments to radiation oncology by 12%.
Again, the impact on specific codes can be far greater.
Reducing the
conversion factor as mandated by statute.
Absent any last-minute intervention by Congress, the conversion factor
is expected to drop by 21%. from
$36.066 to $28.32 This
reduction would be in addition to the cuts mentioned above.
Click here for a detailed summary of the legislation is available on ACRO.org.
What You Need to Do:
ACRO continues to represent the interests of radiation oncologists
meeting directly with members of Congress and with CMS. However, we need your immediate help and your
participation is vital. ACRO is asking
that each member immediately do the following:
· Write a letter to CMS objecting to the proposed
regulations using either a personalized letter or the general letter ACRO has
developed Click here for sample letters.
· Write your Congressman using either a personalized
letter or the general letter ACRO has developed both sample letters are available by clicking here.
· Call your Congressman and share your concerns. This step is especially critical for
radiation oncologists who have any personal relationship with members of
Congress. Congress is currently on its August recess, so many members are
available in their home districts for personal face-to-face meetings
· Work with the allied health professionals in your
organization and urge them to contact their professional associations as well as
write their congressmen. Cuts such as
those currently proposed are unsustainable and will impact jobs.
Get your Patients Involved
Interested cancer patients may
find sample patient letters by clicking here.
We will continue to work on
behalf of the radiation oncology community and appreciate your time and
attention to this matter.
Sincerely,
Michael Kuettel, M.D., Ph.D.,
FACRO, President
Michael Kerley, M.D., FACRO, President
Elect
Paul Wallner, D.O., FACRO, Chair,
Economics Committee
Arve Gillette, M.D., FACRO, Chair,
Government Relations Committee
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